Objective To investigate the impact of using antithrombotic drugs (anticoagulants or antiplatelet aggregation drugs)before the onset of cerebral infarction on hemorrhagic transformation after acute cerebral infarction. Methods The consecutive patients with acute cerebral infarction from Chengdu Stroke Registry Project admitted to the Department of Neurology,West China Hospital,Sichuan University from January 1,2004 to January 1,2014 were enrolled. The baseline data on admission,previous usage of anticoagulants and anti-platelet aggregation drugs,as well as CT/ MRI and other imaging data of all patients were collected. According to the results of CT/ MRI reexamined at 72 h after admission,the patients with hemorrhagic transformation were enrolled into a hemorrhagic transformation group;the patients with non-hemorrhagic transformation were enrolled into a non-hemorrhagic transformation group according to the ratio
of 1 ∶ 1. Their gender and age were matched with the hemorrhagic transformation group. The baseline data and drug used of the patients in both groups were compared. The differences of risk factors between the two groups were analyzed with multivariate Logistic regression analysis. The relationship between hemorrhagic transformation and premorbid use of antithrombotic drugs were observed. Results A total of 6 916 patients with acute cerebral infarction were enrolled,including 433 (6. 3%)hemorrhagic transformation (hemorrhagic transformation group)and 433 non-hemorrhagic transformation. (1)There were significant differences between the patients of the two groups on admission in the National Institutes of Health Stroke Scale (NIHSS)score,atrial fibrillation,previous cerebral infarction,and blood glucose levels on admission (all P < 0. 05). (2)The proportions of using anticoagulants and antiplatelet aggregation agents in the hemorrhagic transformation group were higher than those of the non-hemorrhagic transformation group (anticoagulants:14. 1% [n = 61]vs. 3. 9% [n = 17];P < 0. 01,OR,4. 01,95% CI 2. 303 -6. 993;anti-platelet aggregation drugs:14. 3% [n =62]vs. 8. 3% [n = 36];P = 0. 005,OR,1. 84,95% CI 1. 194 -2. 846). (3)The results of multivariate Logistic regression analysis showed that the use of anticoagu-lants,anti-platelet aggregation drugs,NIHSS score on admission,and random blood glucose on admission were the independent risk factors for hemorrhagic transformation (OR [95% CI]3. 302 [1. 860 -5. 862], 2. 081 [1. 281 -3. 382],1. 047 [1. 026 -1. 069],and 1. 055 [1. 011 -1. 100],respectively (all P <0. 05). Conclusion The NIHSS score and blood glucose levels on admission are the independent risk factors of hemorrhagic transformation. Using anticoagulants or anti-platelet aggregation drugs before symptom onset is independently associated with hemorrhagic transformation,however,its relationship with the long-term prognosis of acute cerebral infarction need to be further studied.

Objective To investigate the effects of safflor yellow (SY) injection on acute lung injury (ALI) rats induced by oleic acid (OA) and its potential mechanism. Methods Wistar rats were randomly divided into six groups,including control group,OA group,OA+10 mg/kg anisodamine group,OA+8 mg/kg SY group,OA+16 mg/kg SY group,and OA+32 mg/kg SY group. Normal saline or anisodamine or SY were pretreated before 0.18 g/kg OA iv injection. The arterial partial pressure of oxygen,the pulmonary water content index,and MPO activity in lung tissue were determined; The mRNA level of TNF-?,IL-1?,IL-6,ICAM-1,and VCAM-1 were measured by RT-PCR; And NF-?B p65 protein in nucleus observed by immunohistochemical technology,while the level of p38 MAPK protein phosphorylation in lung tissue was analyzed by Western blotting. Results The arterial partial pressure of oxygen in all SY groups was higher than that in OA group,while the pulmonary water content index and MPO activity were lower than those in OA group,as well as the mRNA level of the above inflammatory cytokines and the NF-?B p65 in nucleus and level of p38 MAPK phosphorylation. Conclusion SY could alleviate the lung tissue edema,increase the arterial partial pressure of oxygen,and depress MPO activity in ALI rat induced by OA. The SY mechanism of attenuating the acute lung injury may be associated with inhibiting the p38 phosphorylation and NF-?B activation and reducing inflammatory factors expression.

Objective To investigate the genetic association between mutation in cytochrome P450 1A2 (CYP1A2) gene and Erxian suop response. Methods Forty-eight patients with male climacteric syndrome of both Yin and Yang deficiency received a treatment of erxian suop with three months. The severity of symptoms and responses to Erxian suop were quantizated by the method of Department of Psychology in Istanbul Bosphorus University and Clinical Research Guidance Principle on New Drug of Traditional Chinese Medicine published by China. A single nucleotide polymorphism (SNP) at position 2964 (G-A) of CYP1A2 gene were identified by polymerase chain reaction (PCR) in order to analyse the relationship between Erxian response and CYP1A2 single nucleotide polymorphism. Results Statistical analysis showed there was no significant difference among genetype and genetype distribution of CYP1A2 G2964A between the patients and control group. The genotype of the 16 patients among 32 effective patients was G/G (56.25%). The genotype of the 11 patients among 16 ineffective patients was G/A (68.75%). There was no significant difference in symptoms, physical sign between the two groups at the pre-treat and post-treat. Also the two groups had no significant difference among the score of major symptoms and hyposymptoms. Conclusion The patients with genotype of G/G have higher efficiency, while with genotype of G/A have lower efficiency among patients with CYP1A2 G2964A gene when treated with erxian soup.

Objective To investigate the influencing factors of hemorrhagic transformation in non-thrombolysis patients after acute cerebral infarction. Methods According to Chengdu Stroke Registry Project,2598 consecutive patients with acute cerebral infarction admitted to the Department of Neurology,West China Hospital within 1 week of attack from January 2010 to December 2013 were enrolled prospectively. The patients were divided into a hemorrhagic transformation group and a non-hemorrhagic transformation group according to whether they had hemorrhagic transformation or not. As for patients with hemorrhagic transformation,they were divided into a symptomatic hemorrhagic transformation (SHT)group and an asymptomatic hemorrhagic transformation (ASHT)group according to whether they had aggravation of symptom and sign. The baseline data of all patients were collected and compared between the groups. The P<0. 1 variables of the univariate analysis result were enrolled in multivariate logistic regression analysis in order to identify the independent influencing factor of hemorrhagic transformation. Results In 2598 patients,249 (9. 6%)had hemorrhagic transformation,28 of them (1. 1%)were SHT and 221 (8. 5%)were ASHT. There were significant differences in male,hypertension,dyslipidemia,atrial fibrillation,drinking and smoking ratio,blood glucose,cholesterol,low density lipoprotein cholesterol, National Institutes of Health Stroke Scale (NHISS)scores,and the trial of Org 1072 in acute stroke treatment (TOAST)classification between the HT group and the non-HT group (all P<0. 05). There were no significant difference in the related influencing factors between the SHT group and the ASHT group (all P>0. 05). The results of multivariate logistic regression analysis showed that dyslipidemia (OR,0. 588, 95%CI 0. 374-0. 924,P=0. 021)was negatively correlated with hemorrhagic transformation. Atrial fibrillation (OR,3. 188,95%CI 2. 159-4. 707,P<0. 001),blood glucose (OR,1. 081,95%CI 1. 044-1. 119,P<0.001),and NHISS score (OR,1. 305,95%CI 1. 170-1. 455,P<0. 001)were positively correlated with hemorrhagic transformation. In TOAST classification,relative to the large atherosclerotic stroke,the small artery occlusive cerebral infarction was negatively correlated with hemorrhagic transformation (OR,0. 315, 95%CI 0. 167-0. 596,P<0. 001). After removing the influencing factor of atrial fibrillation,compared with the large artery atherosclerotic stroke,cardioembolism stroke was positively correlated with hemorrhagic transformation (OR,2. 823,95%CI 1. 946-4. 095,P<0. 001). Conclusion Dyslipidemia,atrial fibrillation,blood glucose,NHISS score and TOAST classification were independently associated with hemorrhagic transformation in non-thrombolysis patients after acute cerebral infarction.

Objective To compare the hemodynamic responses to orotracheal intubation during emergency operation with the proseal laryngeal mask airway and endotracheal Intubation.Methods Fifty six patients who were ASA GRADE Ⅰ-Ⅱ before onset undergoing orotracheal intubation were randomly dirideed into either without laryngoscope direct proseal laryngeal mask intubation(PLMA) group or direct laryngoscope endotracheal intubation(TT) group.SBP、DBP、HR and SpO2 were recorded before,durring and 5 minutes after intubation.Intubation time and first attempt insertion success rate were recordeddso.All patients were followed up postoperatively for adverse effects like sore throat or hoarseness.Results In intubation time、first attempt insertion success rate and adverse effects like sore throat or hoarseness,PLMA group was 96.43%,(19.7?5.7)s and 7.1%,TT group was 100%,(27.9?11.3)s and 39.29%.Intubation time was significantly shorter and adverse effects like sore throat or hoarseness were lower in the PLMA group than TT group(P

Objective To explore and evaluate the clinical value of MRI for status of axillary lymph node after neoadju-vant chemotherapy (NAC) in patients with breast cancer. Methods Forty-four patients with 1ocally advanced breast cancer (LABC) were underwent NAC for four cycles. The longest diameter of axillary lymph node (ALN) measured by MRI scan. Val-ue of apparent diffusion coefficient (ADC) and their correlation were compared before NAC and four cycles after NAC. Re-sults of MRI and pathological data for ALN were compared between two groups of patients. Results All patients finished four cycles of NAC. The total response rate (CR+PR) was 72.7% (32/44), and the total non-response rate (SD+PD) was 27.3%(12/44). The longest diameter of ALN was significantly shortened in response group. The longest diameter was (1.37± 1.06) cm before NAC and (0.90±0.76) cm after NAC (P<0.01). The ADC value of the tumor was significantly increased in re-sponse group [(0.91±0.28) ×10-3 mm2/s before NAC and (1.01±0.32)×10-3 mm2/s after NAC, P<0.01)]. There was no signifi-cant correlation between ADC value change (△ADC) and the longest diameter change of ALN (△L, r=0.131, P=0.413). The sensitivity, specificity and Kappa value of ALN evaluation after NAC were 100%, 62.5%and 0.68 measured by MRI. Con-clusion The change of tumor longest diameter reflects the effect of chemotherapy directly. The tumor ADC value of MRI can not be used as an independent indicator of chemotherapy effect of ALN, eventhouth MRI was the sensitive index for eval-uating the status of axillary lymph node after neoadjuvant chemotherapy for breast cancer.

Objective: To investigate the epidemiological characteristics of varicella in Yandu District, Yancheng City, Jiangsu Province from 2005 to 2021, so as to provide insights into the improvements of the varicella control strategy. Methods: The data pertaining to cases in Yandu District from 2005 to 2021 were captured from the National Notifiable Diseases Network Reporting System, and the coverage of varicella vaccination in Yandu District from 2016 to 2021 was captured from the Jiangsu Provincial Immunization Planning System. The trends in incidence of varicella were analyzed using annual percent change (APC), the temporal, population and spatial distributions of varicella cases were descriptively analyzed, and the correlation between the cumulative first-dose varicella vaccination rate and incidence of varicella was examined among birth cohorts in Yandu District from 2005 to 2021. Results: Totally 6 144 varicella cases were reported in Yandu District from 2005 to 2021, with annual mean reported incidence of 50.05/105. The incidence of varicella appeared a tendency towards a rise in Yandu District from 2012 to 2018, with APC of 77.97% (t=11.702, P<0.001), and the incidence appeared a tendency towards a decline from 2018 to 2021, with APC of -41.93% (t=-6.911, P<0.001). The incidence of varicella peaked during the period between November and January of the following year (45.95%), and during the period between May and June (20.35%). The mean incidence of varicella was higher among men than among women (54.72/105 vs. 45.00/105; χ2=57.858, P<0.001). The highest incidence of varicella was found among cases at ages of 6 to 9 years (543.78/105), and varicella predominantly occurred among primary school students (38.40%) and pre-school children (31.85%), with high annual mean incidence in the eastern urban areas (74.27/105).The cumulative first-dose varicella vaccination rate negatively correlated with the incidence of varicella among the birth cohorts in Yandu District in 2019 (r=-0.501, P<0.001), 2020 (r=-0.646, P<0.001) and 2021 (r=-0.602, P<0.001). Conclusions The incidence of varicella appeared a tendency towards a rise followed by a reduction in Yandu District from 2005 to 2021, and the incidence of varicella peaked in winter and at the turn from spring to summer, with varicella predominantly found among primary school students and preschool children.

Objective To preliminarily investigate the effect of PBL applied in teaching of Obstetrics and Gynecology. Methods Ninety eight students were randomly divided into PBL pedagogy group and traditional pedagogy group in clinical practice teaching of dysfunctional uterine bleeding. Exam scores were assessed and opinion survey was summarized. Results The exam score was 80.7 ± 5.6 of PBL pedagogy group and 76.3 ± 4.9 of the other group respectively. There was significant difference between the scores of the two groups (P <0.05). Most students consider that PBL pedagogy was of benefit to students' ability. Conclusion PBL pedagogy has more advantages in training of clinical thinking than traditional teaching method.

Objective To introduce distal clavicle excision plus suture anchor to treat Craig Ⅴ distal clavicle fracture.Methods From November, 2005 to August, 2007, 25 patients with Craig Ⅴ distal clavicle fracture were treated with distal clavicle excision plus suture anchor.They were 18 men and 7 women,with a median age of 42.6 years.They were followed up periodically by radiological examination.At the final follow-up, their shoulder functions were evaluated by University of California-Los Angeles (UCLA) scoring system and Constant scoring system, and the pain was evaluated according to visual analog scale (VAS).Results All the patients obtained a median follow-up of 13.6 months (8 to 24) .The height of distal clavicle in all patients reached anatomical reduction.Their average UCLA score was 33.5 (28 to 35), and average Constant score was 90.6 (79 to 100) .Their mean VAS score was 1.2 (0 to 4) .Their average forward flexion and elevation was 156.4° ( 145° to 170°), and external rotation was 45.6° (40° to 60°) .The rate of top quality was 88.0% (22/25).Conclusion Distal clavicle excision plus suture anchor is an effective method to treat Craig Ⅴ distal clavicle fracture which results from serious trauma.